能力验证项目《痰涂片抗酸染色查找抗酸杆菌检测》的情况分析

Analysis of proficiency testing program on AFB smear microscopic examination

目的了解该检测领域的整体水平,加强实验室结核病病原体检测工作的监督管理,提高实验室检测结核病病原体的水平,确保结核病细菌学检测的质量,促进结核病防治工作的开展。方法能力验证样本由10张含不同抗酸杆菌数量的未染色痰涂片组成,参加能力验证实验室收到样本后于2周内完成检测并回报结果。检测方法是用抗酸染色法将痰涂片染色后,用显微镜检测其中的抗酸杆菌。结果全国13个省市的44家实验室参加了本次能力验证项目,其中43家实验室回报了结果。在回报的430张样本中,412张样本的回报结果正确,占95.81%;4张样本的结果为低假阳性,占0.93%;14张样本的结果为量化误差,占3.26%;没有高假阳性和低假阳性的结果出现。结论本次能力验证样本质量和检测结果评估方法满足本次活动的需要;本次能力验证活动客观反映了参加实验室在此项目上的检测能力;开展类似的项目有助于了解该项目的整体水平和督促实验室加强检测工作的质量管理,不断提高实验室综合竞争力。

Objective Understanding of the overall level of AFB smear test area, to strength the management of pathogen detection in TB laboratory and improve the ability of pathogen screening in TB diagnosis, to ensure the quality of AFB sputum smear examination and also to promote the development of tuberculosis control. Methods PT specimens consisting of 10 unstained slides with known AFB numbers were sent to each participant using safety package transport. Acid-fast stain these smears, then microscopically examine them for acid-fast bacilli using the IO00X oil immersion objective lens. The participants were requested to report the results back within 2 weeks after receiving specimens. Results Forty-four domestic laboratories subscribed to the program; 43 laboratories returned results that could be evaluated. The percentages of correct readings were 95.81%（412/430）.The percentages of low false positive were 0.93% （4/430）.The percentages of quantification error were 3.26%（ 14/430）.There were no major errors. Conclusion The results demonstrate the need for and utility of proficiency testing program to further improve the AFB smear identifying performance.